Doctor Name: | EVELYN JEAN TYLER |
NPI Number: | 1033482617 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 200700299228 |
Business Practice Address: | Psc 482 Box 254 Fpo, AP - 963629998 |
Business Phone Number: | 01181611743 |
Business Fax Number: | |
Mailing Address: | Psc 482, Box 254 FPO |
State: | AP |
Postal Code: | 963629998 |
Phone Number: | 01181611743 |
Fax Number: | |
NPI Enumeration Date: | 02/13/2012 |
NPI Last Update Date: | 02/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2100X |
License Number: | 200700299228 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Acute Care |
Taxonomy Definition: |